Psychiatric Mental Health Nurse Practitioner (PMHNP-BC)Medication Management Provider – Job Description
Organization: Adore Her LLC DBA Gracious Hearts Wellness & Recovery
Position: Psychiatric Mental Health Nurse Practitioner (PMHNP-BC)
Department: Behavioral Health Services
Employment Type: 1099 Independent Contractor / Part-Time
Reports To: Executive Director/Agency Administrator
Location: Hybrid/Telehealth as approved by agency policy, payer requirements, and applicable North Carolina law
COMPENSATION
90792 – Psychiatric Diagnostic Evaluation with Medical Services: $65 per completed visit
99213 – Established Patient Medication Management: $35 per completed visit
99214 – Established Patient Medication Management: $45 per completed visit
99215 – Established Patient Medication Management: $60 per completed visit
Payment is issued only for completed services with all required documentation completed, signed, and compliant with agency and payer requirements.
Position Summary
Gracious Hearts Wellness & Recovery is seeking a qualified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) to provide psychiatric assessments, medication management, prescribing, and ongoing psychiatric follow-up services to behavioral health clients.
The PMHNP is responsible for independently performing duties within the provider’s legal scope of practice while complying with North Carolina licensure requirements, federal and state regulations, Medicaid requirements, managed care organization requirements, agency policies, and professional standards of care.
The PMHNP will work collaboratively with agency leadership, administrative staff, qualified professionals, therapists, peer support staff, and other treatment team members as applicable.
Minimum Qualifications
The provider must:
- Hold an active and unrestricted Registered Nurse license in North Carolina or applicable multistate authorization.
- Hold an active and unrestricted Advanced Practice Registered Nurse/Nurse Practitioner authorization in North Carolina.
- Be board-certified as a Psychiatric Mental Health Nurse Practitioner, preferably PMHNP-BC.
- Maintain all required prescribing authority.
- Maintain an active DEA registration when prescribing controlled substances is within the provider's role.
- Maintain an active individual Type 1 NPI.
- Maintain an appropriate psychiatric nurse practitioner taxonomy.
- Be eligible for enrollment and credentialing with NC Medicaid and applicable managed care organizations.
- Maintain professional liability/malpractice insurance at limits required by the agency and applicable payer contracts.
- Successfully complete all required background checks, exclusion checks, credential verification, and agency onboarding requirements.
Primary Clinical Responsibilities
The PMHNP will be responsible for providing psychiatric services including, but not limited to:
Psychiatric Diagnostic Evaluations
Conduct comprehensive psychiatric diagnostic evaluations for new clients when medically necessary.
Evaluations may include:
- Presenting psychiatric concerns.
- Chief complaint.
- History of present illness.
- Psychiatric history.
- Previous diagnoses.
- Previous psychiatric hospitalizations.
- Previous medication trials.
- Current medications.
- Medication allergies.
- Medical history.
- Substance use history.
- Family psychiatric history.
- Social history.
- Trauma history when clinically appropriate.
- Mental status examination.
- Suicide and homicide risk assessment.
- Clinical formulation.
- DSM-5-TR diagnosis when appropriate.
- Medication recommendations.
- Treatment recommendations.
- Referrals when indicated.
Medication Management
Provide ongoing psychiatric medication-management appointments for established clients.
Responsibilities include:
- Reviewing response to medication.
- Evaluating effectiveness.
- Monitoring side effects.
- Assessing medication adherence.
- Reviewing changes in symptoms.
- Reviewing current medication lists.
- Checking for medication interactions.
- Adjusting dosages when clinically appropriate.
- Starting or discontinuing medications when indicated.
- Providing medication education.
- Ordering laboratory monitoring when necessary.
- Coordinating with primary care and specialty providers.
- Documenting the clinical rationale for medication decisions.
Prescribing Responsibilities
The PMHNP is responsible for all prescriptions issued under their credentials.
The provider must:
- Prescribe only within legal scope of practice.
- Follow federal and state prescribing laws.
- Follow controlled-substance requirements when applicable.
- Review prescription-monitoring systems when required.
- Respond to pharmacy questions and medication-related concerns.
- Document medication changes, discontinuations, and refills.
- Maintain appropriate follow-up intervals.
Agency personnel may not direct the PMHNP to prescribe a specific medication.
Informed Consent for Medication
Before initiating psychiatric medication, the PMHNP must ensure appropriate informed consent has been completed.
The PMHNP must discuss, as clinically appropriate:
- Medication name and purpose.
- Expected benefits.
- Common side effects.
- Significant risks.
- Alternatives.
- Relevant drug interactions.
- Pregnancy or reproductive considerations when applicable.
- Controlled-substance risks when applicable.
Administrative staff may send the agency’s Informed Consent for Medication form to the client; however, the PMHNP remains responsible for confirming that informed consent is clinically appropriate and documented.
Documentation Requirements
All documentation must be completed accurately and within agency-required timeframes.
The PMHNP is expected to complete documentation within 24–48 hours of the service, unless a more stringent payer requirement applies.
Documentation must support:
- Medical necessity.
- Diagnosis.
- Service provided.
- Client symptoms.
- Mental status.
- Clinical assessment.
- Medication review.
- Medication changes.
- Side effects.
- Risk assessment.
- Client education.
- Treatment plan.
- Follow-up recommendations.
- Referrals when appropriate.
The PMHNP must use the agency-approved electronic health record and designated templates.
CPT / Service Expectations
Depending on credentialing, payer approval, medical necessity, and services actually rendered, the provider may provide services associated with:
- 90792 – Psychiatric Diagnostic Evaluation with Medical Services
- 99213 – Established Patient Evaluation and Management
- 99214 – Established Patient Evaluation and Management
- 99215 – Established Patient Evaluation and Management
The PMHNP must select and document the service level that accurately reflects the service performed and may not select a code solely based on reimbursement.
Follow-Up Care
The PMHNP is responsible for determining clinically appropriate follow-up frequency.
The provider must:
- Establish follow-up appointments based on client needs.
- Identify clients who require closer monitoring.
- Document recommended follow-up intervals.
- Notify staff when urgent follow-up is needed.
- Coordinate referrals to higher levels of care when necessary.
Crisis and Safety Responsibilities
The PMHNP must appropriately assess and respond to psychiatric emergencies identified during appointments, including:
- Suicidal ideation.
- Homicidal ideation.
- Psychosis.
- Severe medication reactions.
- Acute intoxication or withdrawal.
- Severe psychiatric decompensation.
When clinically indicated, the PMHNP must complete appropriate risk assessment, make crisis or emergency referrals, and document actions taken.
Communication With Treatment Team
The provider is expected to collaborate appropriately with:
- Therapists.
- Qualified Professionals.
- Peer Support Specialists.
- Primary care providers.
- Pharmacists.
- Hospitals.
- Crisis providers.
- Care managers.
- Guardians or authorized representatives when applicable.
Medication Refills
The PMHNP is responsible for determining whether:
- A refill is clinically appropriate.
- An appointment is required before a refill.
- Laboratory monitoring is needed.
- The client has missed required follow-up.
- Medication should be continued or changed.
Administrative staff may route refill requests but may not authorize medication.
Laboratory and Medical Monitoring
The PMHNP is responsible for ordering and reviewing clinically necessary monitoring associated with psychiatric medication and documenting any resulting clinical action.
Telehealth Expectations
When telehealth is used, the PMHNP must comply with:
- Applicable North Carolina and federal requirements.
- Payer telehealth policies.
- HIPAA requirements.
- Agency telehealth policies.
- Prescribing requirements.
Scheduling and Availability
The PMHNP must:
- Maintain assigned appointment blocks.
- Arrive or log in on time.
- Notify the agency of schedule changes.
- Provide reasonable notice for planned absences.
- Complete documentation within required timelines.
- Respond to clinically relevant communications within agreed-upon timeframes.
Credentialing Responsibilities
The provider must cooperate fully with credentialing and timely provide:
- Licenses.
- Certifications.
- DEA registration when applicable.
- NPI.
- Taxonomy.
- CAQH information.
- Malpractice insurance.
- Education and employment verification.
- Medicaid enrollment information.
- Managed care credentialing documents.
The provider must immediately notify the agency of any licensure restriction, board action, exclusion, credentialing change, or other circumstance affecting eligibility to practice or bill.
Compliance Expectations
The PMHNP must comply with:
- HIPAA.
- 42 CFR Part 2 when applicable.
- NC Medicaid requirements.
- Managed care organization requirements.
- Fraud, waste, and abuse standards.
- Licensing board requirements.
- Agency policies and procedures.
- Documentation standards.
- Client-rights requirements.
Quality Assurance
The PMHNP must participate in quality assurance activities as requested, including:
- Documentation audits.
- Medication-management audits.
- Record reviews.
- Corrective action.
- Credentialing reviews.
- Compliance training.
- Performance-improvement activities.
Professional Conduct
The PMHNP is expected to:
- Treat clients respectfully.
- Maintain professional boundaries.
- Practice within scope.
- Maintain confidentiality.
- Provide culturally responsive care.
- Communicate professionally.
- Maintain accurate and truthful documentation.
- Refrain from falsifying or improperly altering records.
Performance Expectations
Successful performance includes:
- Timely psychiatric evaluations.
- Timely medication-management follow-ups.
- Documentation completed within required timeframes.
- Appropriate medication monitoring.
- Appropriate informed-consent documentation.
- Appropriate risk assessments.
- Timely response to clinically significant concerns.
- Maintenance of active credentials.
- Compliance with payer and agency requirements.
Scope of Practice
Nothing in this job description authorizes the PMHNP to perform services outside their legal or professional scope of practice.
The PMHNP retains responsibility for independent clinical decision-making and must decline requests that are unsafe, medically inappropriate, unethical, illegal, or outside scope.
Job Type: Contract
Pay: From $109,152.25 per year
Work Location: Remote
